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Relationships ‘have got better and better over past year’

RELATIONSHIPS between GPs and hospital doctors are now very good, the finances are being tackled and integrated care is being addressed – say health bosses.

Dr David Rogers

It follows publication of the recent report which highlights deep-rooted tensions between the Primary Care Trust and the health trust which runs West Cumberland Hospital and Cumberland Infirmary.

Copeland’s lead GP, David Rogers, told The Whitehaven News that relationships between the two trusts were in a different place now.

“Relationships have got better and better over the past 12 months, certainly in the West we now have very good relationships,” he said.

Regarding the integration of services and Closer to Home, Dr Rogers said: “The hospitals trust didn’t engage in the process as they could have or should have but relationships have come on a lot since then.

“We need to make sure that we have patients in hospitals when appropriate and in the community when appropriate and have clinicians working together.

“The clinical strategy is about working together, if we don’t integrate services and work co-operatively we won’t be able to do things in the future for our patients,” said the Whitehaven GP.

“We want to see things happen next year.”

Regarding Closer to Home not reducing hospital admissions enough, Dr Rogers said that if the integrated services had been in place earlier – such as an emergency floor where patients would be seen by an appropriate senior doctor early on in the assessment process – then more unnecessary hospital admissions could have been prevented.

And he said the reason less money was invested in community services was because the PCT had to give the hospitals trust £70 million above what was expected.

Dr Rogers added: “The hospitals have been unable to live within their means and haven’t met cost improvement targets. They now have a lot to do in a short space of time. In reality can it be done by April 1? No it can’t,” he said.

“But we now have a clinical services strategy with clinicians and management wanting to make changes. We have to make sure we have got safe sustainable services into the future.”

Mike Walker, a surgeon and medical director for West Cumberland Hospital and the Cumberland Infirmary, agreed that relationships were now much better.

“Over the past three years the senior clinicians in primary and secondary care have worked very hard to bridge the gap that opened up at a management level,” said Mr Walker.

“I don’t recognise that report as where we are now. We are now trying to work as a family rather than three tribes (west/east and the primary care trust).”

Mr Walker said he believed that both clinicians and managers need to be 100 per cent accountable for the poor relationships in the past.

Regarding Closer to Home he said there had been a lack of clarity as to how the original savings in the plan would be achieved.

“There wasn’t the engagement and collaborative working then to make the changes in primary and secondary care.” He said there was blame on both sides for that.

And tackling the finances is not an easy task, he said.

“There’s only one pot of money and I don’t believe that the primary care trust or the acute trust can do this on their own. The only way of doing it is to work together for the benefit of the public.”

He said the costed clinical strategy – which details what services will be in the hospitals – was expected to be ready at the end of November but would now be the end of January. “I believe that it is affordable as long as we work together.”

And the hope is that the business case for the West Cumberland Hospital redevelopment will be submitted and approved by regional health bosses also in January.

Mr Walker said there was no doubt that the redevelopment had been delayed but he said that the new-build part could not start in any case until the mental health facility on site (Yewdale) had moved into its new location.

He said this would be complete around May/June next year and that hopefully it would allow building work to start in September.

Regarding the reduction in emergency treatment not being as significant as it should have been, Mr Walker said the drop that was seen was partially down to Closer to Home but also changes in the way treatment is now coded.

He said the hospitals still needed a large amount of money because there was still a lot of people coming through their doors to be treated so either Closer to Home had not worked as well as it should have or that people were getting sicker.

He added that it was hoped the emergency floor would be delivered at both hospitals in April/May time to help give an early senior diagnosis for patients.